Tuesday, November 18, 2008

A Long Road to Tipperary

We have been doing the PD dialysis for a little over a month now. It is a lot easier than I thought that it would be for me. It is all about establishing a routine and that makes it easier to get into a rhythm and do it every day.
I have only contaminated the end of his exchange set once and I am not sure if I really did contaminate it- I just assumed that I did and drove Larry down to Delafield to get the exchange set changed out.
We do have some issues yet. The first and main issue is...we are supposed to weigh Larry every day when he gets up to see how we are doing at managing his fluid levels. They gave us this really nice digital scale. Unfortunately, the digital scale does not stay on long enough to get a weight. By the time Larry steps on the scale and gets himself balanced enough to let go, it shuts off. We tried everything. Biz and I finally(with Phrog's assistance and sawing skill) built a wooden frame to put around the scale so Larry could walk a step or two before stepping onto the scale (not UP onto the scale). Still could not balance enough to get a weight.
I do have a regular scale- with a dial, but, again, the balance thing is an issue and he can only let go of his walker for about 1/2 second, so if I am not looking at the right place in the fraction of an instant- too bad, so sad, no weight today. I do try to have him do it again and sometimes it works, but some days, he won't even try to get on the scale at all because he is too wobbly.
The second issue is trying to adjust taking fluid off without dehydrating him. He gets dehydrated so easily and I have been tweeking the combination of solutions to try to take off some fluid and keep his weight down. To make it more difficult 1.5 % solution doesn't even do anything, so I have to use a combo of 2.5% and 4.25%-the stronger I use the more fluid comes off. BUT.... also the more deydrated he gets because it is pulling fluid from places that don't need fluid pulled instead of places that it needs to come off of.
The result is, he has been very wobbly after his afternoon exchanges since Friday. So,5 days of afternoon and into evening wobbly. How fun is that?
I think that eventually, his body will get used to the fluid coming off this way and even out, but, it is mentally wearing to have the same discussions with Larry every day.
"Yes Larry, you are a little weak and wobbly."
"No Larry, you are not worse than you have ever been."
"Yes Larry, you can stand up, we just have to keep trying."
"Calm down.....Breath through your nose Larry."
"I think that you are dehydrated Larry. So have some sips of water while you are watching tv."
And on and on, reassuring him and trying to keep him focused because he has a tendancy to sink into poor me, poor poor pitiful me. Which really does not do him one bit of good, but he does enjoy a good pity party-as do we all.
So, overall- this PD dialysis right now is a mixed bag of nuts- mostly good and hopefully, all will be well as we progress.

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